Statement of Principles concerning cardiac myxoma (Reasonable Hypothesis) (No. 32 of 2017)

Administered by Department of Veterans' Affairs

Legislation au F2017L00463 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

 

STATEMENT OF PRINCIPLES CONCERNING

CARDIAC MYXOMA

(REASONABLE HYPOTHESIS) (NO. 32 OF 2017)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1. This is the Explanatory Statement to the Statement of Principles concerning cardiac myxoma (Reasonable Hypothesis) (No. 32 of 2017).

Background

2.             The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA), revokes Instrument No. 11 of 2009, determined under subsection 196B(2) of the VEA concerning cardiac myxoma.

3.             The Authority is of the view that there is sound medical-scientific evidence that indicates that cardiac myxoma and death from cardiac myxoma can be related to particular kinds of service.  The Authority has therefore determined pursuant to subsection 196B(2) of the VEA a Statement of Principles concerning cardiac myxoma (Reasonable Hypothesis) (No. 32 of 2017).  This Instrument will in effect replace the revoked Statement of Principles.

Purpose and Operation

4.             The Statement of Principles will be applied in determining claims under the VEA and the Military Rehabilitation and Compensation Act 2004 (the MRCA).

5.             The Statement of Principles sets out the factors that must as a minimum exist, and which of those factors must be related to the following kinds of service rendered by a person:

 operational service under the VEA;

 peacekeeping service under the VEA;

 hazardous service under the VEA;

 British nuclear test defence service under the VEA;

 warlike service under the MRCA;

 non-warlike service under the MRCA,

before it can be said that a reasonable hypothesis has been raised connecting cardiac myxoma or death from cardiac myxoma, with the circumstances of that service.  The Statement of Principles has been determined for the purposes of both the VEA and the MRCA.

6.             This Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 3 May 2016 concerning cardiac myxoma in accordance with section 196G of the VEA.  The investigation involved an examination of the sound medical-scientific evidence now available to the Authority, including the sound medical-scientific evidence it has previously considered.

7.             The contents of this Instrument are in similar terms as the revoked Instrument.  Comparing this Instrument and the revoked Instrument, the differences include:

  • adopting the latest revised Instrument format, which commenced in 2015;
  • specifying a day of commencement for the Instrument in section 2;
  • revising the definition of 'cardiac myxoma' in subsection 7(2);
  • revising the reference to 'ICD-10-AM code' in subsection 7(4);
  • revising the factor in subsection 9(1) concerning 'heart transplant';
  • new definitions of 'MRCA' and 'VEA' in Schedule 1 - Dictionary; and
  • revising the definition of 'relevant service' in Schedule 1 Dictionary.

Consultation

8.             Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to cardiac myxoma in the Government Notices Gazette of 3 May 2016, and circulated a copy of the notice of intention to investigate to a wide range of organisations representing veterans, service personnel and their dependants.  The Authority invited submissions from the Repatriation Commission, organisations and persons referred to in section 196E of the VEA, and any person having expertise in the field.  No submissions were received for consideration by the Authority during the investigation.

Human Rights

9.             This instrument is compatible with the Human Rights and Freedoms recognised or declared in the International Instruments listed in Section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.  A Statement of Compatibility with Human Rights follows.

Finalisation of Investigation

10.         The determining of this Instrument finalises the investigation in relation to cardiac myxoma as advertised in the Government Notices Gazette of 3 May 2016.

References

11.         A list of references relating to the above condition is available to any person or organisation referred to in subsection 196E(1)(a) to (c) of the VEA.  Any such request must be made in writing to the Repatriation Medical Authority at the following address:

The Registrar

Repatriation Medical Authority

GPO Box 1014

BRISBANE    QLD    4001

Statement of Compatibility with Human Rights

(Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011)

 

Instrument No.:   Statement of Principles No. 32 of 2017

Kind of Injury, Disease or Death: Cardiac myxoma

 

This Legislative Instrument is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.

Overview of the Legislative Instrument

1. This Legislative Instrument is determined pursuant to subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA) for the purposes of the VEA and the Military Rehabilitation and Compensation Act 2004 (the MRCA).  Part XIA of the VEA requires the determination of these instruments outlining the factors linking particular kinds of injury, disease or death with service such being determined solely on the available sound medical-scientific evidence.

2. This Legislative Instrument:-

  • facilitates claimants in making, and the Repatriation Commission in assessing, claims under the VEA and the MRCA respectively, by specifying the circumstances in which medical treatment and compensation can be extended to eligible persons who have cardiac myxoma;
  • facilitates the review of such decisions by the Veterans' Review Board and the Administrative Appeals Tribunal;
  • outlines the factors which the current sound medical-scientific evidence indicates must as a minimum exist, before it can be said that a reasonable hypothesis has been raised, connecting cardiac myxoma with the circumstances of eligible service rendered by a person, as set out in clause 5 of the Explanatory Statement;
  • replaces Instrument No. 11 of 2009; and
  • reflects developments in the available sound medical-scientific evidence concerning cardiac myxoma which have occurred since that earlier instrument was determined. 

3. The Instrument is assessed as being a technical instrument which improves the medico-scientific quality of outcomes under the VEA and the MRCA. 

Human Rights Implications

4. This Legislative Instrument does not derogate from any human rights. It promotes the human rights of veterans, current and former Defence Force members as well as other persons such as their dependents, including:

  • the right to social security (Art 9, International Covenant on Economic, Social and Cultural Rights; Art 26, Convention on the Rights of the Child and Art 28, Convention on the Rights of Persons with Disabilities) by helping to ensure that the qualifying conditions for the benefit are 'reasonable, proportionate and transparent'[1];
  • the right to an adequate standard of living (Art 11, ICSECR; Art 27, CRC and Art 28, CRPD) by facilitating the assessment and determination of social security benefits;
  • the right to the enjoyment of the highest attainable standard of physical and mental health (Art 12, ICSECR and Art 25, CRPD), by facilitating the assessment and determination of compensation and benefits in relation to the treatment and rehabilitation of veterans and Defence Force members;
  • the rights of persons with disabilities by facilitating the determination of claims relating to treatment and rehabilitation (Art 26, CRPD); and
  • ensuring that those rights "will be exercised without discrimination of any kind as to race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status" (Art 2, ICESCR).

Conclusion

This Legislative Instrument is compatible with human rights as it does not derogate from and promotes a number of human rights.

 

Repatriation Medical Authority

 

 

 

 

 

[1] In General Comment No. 19 (The right to social security), the Committee on Economic, Social and Cultural Rights said (at paragraph 24) this to be one of the elements of ensuring accessibility to social security.

Overview

The Statement of Principles concerning Cardiac Myxoma (Reasonable Hypothesis) (No. 32 of 2017) was introduced by the Repatriation Medical Authority under subsection 196B(8) of the Veterans' Entitlements Act 1986 to address the issue of cardiac myxoma and its relation to military service, replacing the previously revoked Instrument No. 11 of 2009. This legislative instrument is designed to facilitate the assessment of claims for medical treatment and compensation for veterans and members of the Defence Force who have developed cardiac myxoma, by outlining the minimum factors that must be present and related to specific types of service for a reasonable hypothesis to be raised connecting the condition to the service rendered. The Statement of Principles sets the criteria for operational, peacekeeping, hazardous, British nuclear test defence, warlike, and non-warlike service as outlined under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. The policy objective is to ensure that the qualifying conditions for benefits are reasonable, proportionate, and transparent, thereby promoting the human rights of veterans and their dependents.

Scope and Application

The Statement of Principles concerning cardiac myxoma (Reasonable Hypothesis) (No. 32 of 2017) applies to individuals who are seeking medical treatment and compensation for cardiac myxoma under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). These Acts cover veterans, current and former Defence Force members, and other persons such as their dependents. The Statement of Principles sets out the minimum factors that must exist and be related to specific kinds of service, such as operational, peacekeeping, hazardous, British nuclear test defence service, warlike, and non-warlike service, before it can be said that a reasonable hypothesis has been raised connecting cardiac myxoma or death from cardiac myxoma with the circumstances of that service. The instrument replaces the previously revoked Instrument No. 11 of 2009 and reflects the latest available sound medical-scientific evidence concerning cardiac myxoma. It is compatible with human rights as it does not derogate from and promotes a number of human rights, including the right to social security, the right to an adequate standard of living, and the right to the enjoyment of the highest attainable standard of physical and mental health. The scope and application of the Statement of Principles are limited to the Commonwealth of Australia and the VEA and MRCA. The instrument does not specify any exclusions, exemptions, or thresholds. The Authority may extend or restrict the application of this instrument through subordinate instruments, but no such instruments are mentioned in the explanatory statement.

Key Provisions

The Statement of Principles concerning cardiac myxoma (Reasonable Hypothesis) (No. 32 of 2017) primarily operates under sections 196B(2) and 196B(8) of the Veterans' Entitlements Act 1986 (VEA) and is intended for application in claims under the VEA and the Military Rehabilitation and Compensation Act 2004 (MRCA). It outlines the minimum factors that must exist and be related to specified types of service, such as operational, peacekeeping, hazardous, British nuclear test defence, warlike, and non-warlike service, before a reasonable hypothesis can be established linking cardiac myxoma or death from cardiac myxoma with the service circumstances (section 5). The Statement of Principles also incorporates the latest revised Instrument format, updates definitions, and revises references to align with current medical coding and terminology (subsections 7(2) and 7(4), and subsection 9(1)). Under the Act, the Repatriation Medical Authority is responsible for determining these Statements of Principles based on sound medical-scientific evidence. The Authority is obligated to investigate claims, review available evidence, and consult with relevant stakeholders, including veterans' organisations and experts in the field (sections 196G and 196E of the VEA). The process involves advertising the intention to investigate in the Government Notices Gazette and inviting submissions from interested parties, although in this case, no submissions were received (section 8). Breaches of the requirements set out in the Statement of Principles may not directly result in offences under the VEA or MRCA. However, failure to comply with the principles in the assessment of claims could lead to disputes and potential reviews by the Veterans' Review Board and the Administrative Appeals Tribunal. While the Statement of Principles itself does not prescribe specific penalties, non-compliance or mismanagement of claims could lead to civil or administrative consequences, including the need for corrective actions or adjustments in compensation and benefits. The Statement of Principles ensures that the human rights of veterans and Defence Force members are respected and promoted, particularly the rights to social security, an adequate standard of living, and the highest attainable standard of physical and mental health. It is explicitly stated that the Legislative Instrument is compatible with human rights and does not derogate from any of the rights recognised under international instruments (section 9). The Authority's determination process, including consultation and investigation, is designed to uphold these rights and ensure that benefits are awarded fairly and transparently.

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